View report page

adequate, but there was so much additional work that we were
stretched to the limit. New problems were created by immigrant
children and their parents, who in an increasing number required our
support. Many of these children had only recently been reunited
with their parents in this country after years of separation during
the most impressionable years of their lives, and they reacted to the
strange new environment and completely different cultural pattern by
considerable aggressiveness in school, and caused their parents
frequent concern by their wayward behaviour. The children who had
been used to a considerable amount of corporal punishment in homes
and schools overseas cannot understand our less punitive methods of
disciplining here, mistaking our more kindly verbal approach and
reluctance to use the cane, for tolerance or even condoning their
behaviour, with the result that they are very bewildered when ultimately
more energetic measures do appear necessary.
Our conventional casework approach and playtherapy techniques
require considerable modification and new thinking on our part.
The parents' unusual hours of work, the language barrier, and above
all the completely different pattern of intra-familial relationships,
which is based on the concept of an extended family circle where the
grandmother assumes the maternal role and other relative may take
over near-parental responsibilities, make traditional methods of treatment
and concepts of theory invalid. Many of the problems are
fundamentally caused by the difficulties the child has in coping in
the changed physical and social environment, and his frustration
in making himself understood. The result is that often very little
can be done for these cases at the child guidance clinic, apart from
explaining the position to everybody concerned and stressing the need
for the child to have time to adjust.
This year we had a fair number of referrals from private
schools, and the co-operation with the staff and attention given to
parents and children was in no way different to the schools administered
by the Local Authority.
The child psychiatrist can probably observe certain side effects
on the community due to the Mental Health Act 1959 better than his
colleagues in the mental hospital, as he observes at close range the
disturbing effect in the home on the emotional stability of the children
who are living with mentally unbalanced adults, who often suffer from
florid delusions or severe agitated depressions. This is a comparatively
new development of Community Mental Health Therapy and remains
an unsolved problem in an otherwise progressive and most welcome
approach to mental illness. It appears to me that the concept of
the modern Community Mental Health Service could break down if
more support for families with mentally unbalanced members, by
increasing the number of trained caseworkers, is not forthcoming.
An interim solution would seem to be, as has been shown in other
areas, to base the Community Mental Health Service on a greatly
extended local child guidance clinic, which would have the advantage
of its considerable experience in working within families and coordinating
different social agencies. The fact that child psychiatry
75